99% of women who die in childbirth or from pregnancy-related complications live in developing countries. Conflicts, natural disasters and epidemics make access to healthcare even more difficult. To reduce maternal mortality and guarantee timely access to qualified personnel on the hottest fronts of war and humanitarian emergency, the Doctors Without Borders organization is active with thousands of humanitarian workers: gynecologists, midwives and psychologists.
On the occasion of Mother’s Day, we collected the testimony of some Italian midwives, veterans of MSF missions who contributed to making the miracle of generating new lives possible in devastated countries.
Chiara Ligabue, 30 years old – midwife in Benin
“Thanks to my work I am close to women in the moment that should be the happiest of their lives: childbirth. In Benin, however, women are aware of how much this event, for them, also represents a moment in which they can risk to die. For this reason, if all goes well, the joy is amplified, even for us who contribute to this miracle.” Chiara Ligabue, a young midwife from Modena, tells the story with passion.
Fresh from his first mission in Benin, as part of the MSF maternal and child health project, he underlines how precarious the accessibility to care is. “Women also have to pay to give birth or for emergency care, as in the case of hemorrhages – she says -. For this reason, most of them are forced to give birth at home, assisted by other women from the village instead of medical staff qualified. Often, if any complications arise, it is too late to save the situation.”
International Day of Midwives, alongside women to help them face childbirth with peace of mind
by Emilio Piccione
Connections and means of transport are lacking, as are roads and night lighting. The healthcare facilities are equally dilapidated, lacking adequate equipment and often in disastrous hygienic conditions, thus contributing to increasing maternal and neonatal mortality. “In many cases there is no water and there are not even the means to sterilize the surgical instruments, which are antiquated among other things. Unlike Italy, where we are used to working in teams, it happens that the midwife finds herself alone to manage a patient’s emergency, without a medical history”, says Ligabue, underlining the support of MSF: competence and free treatment are the cornerstones, in a reality where, in many cases, even the gauze must be paid for by the patient.
His day in Benin is also marked by awareness-raising activities in the villages. Together with her local colleagues, she informs women about the possibility of accessing free healthcare and, above all, explains to them the importance of taking care of themselves and their children. They are active on the contraception front, fighting against widespread stigma. “We explain its usefulness, in order to space one birth from another, avoiding compromising the woman’s health, but unfortunately the decisive factor remains the husband’s decision”.
Maria Rosaria Trivisonno, 39 years old – midwife in Afghanistan
Her name is Maria Rosaria Trivisonno and she is a 39-year-old midwife from Campobasso: she has been collaborating with MSF in various crisis areas for over 10 years. “I work in areas where even being a woman represents an obstacle to accessing care,” she explains. You are referring to the situation in Afghanistan, where women’s rights are increasingly compromised. “Although pregnant women, as well as children under five years of age, are considered vulnerable and, therefore, subjected to greater attention by the authorities, they are subject to strong limitations. For medical procedures, the signature of the husband or a male relative. And the care – he specifies – can only be provided by female healthcare personnel”.
In the maternal and child hospital in Khost – where 2,000 children are born per month (numbers that an Italian hospital reaches on average in about a year) – MSF also provides training courses for young midwives. They transfer skills to Afghan girls, promoting their socio-economic independence and improving accessibility to care. “Due to the lack of female professional figures, women often do not go to hospital. It also happens in complicated circumstances, which represent around 15% of all pregnancies. This is why many women end up losing their lives, not having access to adequate care in time” .
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There is often a shortage of drugs and diagnostic tools, roads are blocked and distances are insurmountable. “The constant relationship with the local community represents the fulcrum of our missions. Supporting these women during childbirth lights up a light of hope in the darkest darkness. The music of life represents the strength to look towards the future, despite suffering” he adds , while reflecting on the value of freedom that these women sometimes find within the walls of Doctors Without Borders facilities.
Trivisonno encounters dramatic and extraordinary stories on a daily basis. Like that of a woman with her first twin pregnancy, who arrived at the hospital after a long journey, already in labor. “It was New Year’s Eve: her condition was compromised as she suffered from malaria, but the cry of her two children allowed us to welcome the new year with joy”.
Benedetta Capelli, 35 years old – midwife between Haiti and Greece
Many lives have been saved also thanks to Benedetta Capelli, a 35-year-old midwife from Piacenza, who talks about her mission in Haiti. “It is one of the most difficult contexts in which I have worked: the situation of violence in Port au Prince is incomparable. I had to learn to live with it, always continuing to fight”, she admits.
Women are relegated to the margins of an oppressive system, despite playing a central role in supporting the family. “If they are missing, the social system collapses. In countries with an extremely high maternal mortality rate, we immediately understand the importance of keeping all the women who access our services alive and healthy, whether for a birth or for a contraception visit. We don’t just treat women, but the entire village”, underlines Capelli.
Pregnancy, problems after childbirth for one in three women
by Celeste Ottaviani
Giving birth safely is, however, a chimera. Chronic violence often prevents people from leaving home to receive treatment or the hospital is too far to reach. “Many young women come to us when their life, and that of their child, is hanging by a thread” she sighs. But he is keen to point out the resilience of these women: “Among hundreds of people crowded on a dinghy, we also find exhausted children and pregnant women. In those desperate situations we have to apply emergency clinical protocols. There is great tension, but to help bringing new lives to light in the middle of the sea heartens everyone” he explains, mentioning the experience in Greece, at the gates of Europe, where many migrants knock.
“I meet many women who have gone through hell on the migratory routes. Death is tangible in their eyes. We try to heal their wounds. Even those of the soul”.
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– 2024-05-12 05:22:36
